Is documentation and quality assessment associated with patient satisfaction in benign prostate hypertrophy?

Generally, in Europe quality assurance is demanded increasingly in health care settings. European Health Act specifies new demands concerning quality assurance through documentation, monitoring of health services and follow-up considering patient flow and optimal use of resources. The aim of this study was to investigate the agreement between European guidelines and clinical practice and the association between patient satisfaction and level of documentation, recommendations and improvements of voiding function in patients with benign prostate hypertrophy (BPH). The study population encompassed men between 60 and 80 years referred to specialist treatment due to lower urinary tract symptoms. Random samples of 250 medical records were extracted from national registers. Indicators were reported as proportions. Bivariate and multivariate analyses were reported as odds ratio with a 95% confidence interval. A total of 178 patient pathways were included, and the overall documentation rate was 77%. Agreement between national recommendations and clinical practice was found in 38%. No significant associations were found regarding patient satisfaction and level of documentation, adherence to national guidelines and improvements of the voiding function. There is a need for stringency in quality assessment and reporting indicators to national databases and increased application of European evidence-based guidelines. More complete are necessary for decision-makers in the future to qualify management of BPH rehabilitation ensuring the quality of the individual patient pathways.